Title : Profiling, prescribing patterns and infection rates among inpatients at orthopedics wards: Prospective interventional implementation study (AMSP-PIIS)
Abstract:
Background: Trauma represents a significant public health issue in India, with substantial morbidity and mortality. Rapid access to appropriate care is essential for favorable post-injury outcomes. However, resource allocation strategies ensuring equitable access in developing nations are not well defined. Orthopedic surgeries are significant contributors to surgical site infections (SSIs) globally. The inappropriate use of antibiotics contributes to antimicrobial resistance (AMR), a critical global health concern. Antimicrobial stewardship is advocated as a key strategy to address AMR, yet practical examples of stewardship in trauma centers are limited. This study aims to assess profiling, prescribing patterns, and infection rates among inpatients in orthopedics wards at a level 1-trauma center in India.
Methods: This prospective interventional study focused on patients admitted to orthopedic wards following traumatic injuries.
Results: Over a 6-month period, 408 patients with traumatic injuries were included in the study. The demographic profile revealed a mean age 38.7+13.7, with 80% male and 20% female patients. Lower limb fractures were the most common injury, followed by spinal injuries. The majority of patients were prescribed antibiotics prophylactically. The mean length of stay was 10.96 days. Patients who developed confirmed surgical site infections were 4.4%, with Klebsiella pneumoniae and Escherichia coli being the most commonly isolated organisms. Most patients were discharged from the hospital.
Conclusion: This study highlights the necessity of implementing antimicrobial stewardship programs tailored to orthopedic patients. Such programs are critical for optimizing antibiotic use, combating AMR, and reducing the incidence of hospital-acquired infections (HAIs). Addressing implementation challenges and enhancing prescribing practices are vital steps toward mitigating antimicrobial resistance and advancing patient care within orthopedic settings.
